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Pre/Post Op - Posterior Cervical Fusion - Dr. Abbasi

PRE OP INSTRUCTIONS

Posterior Cervical Fusion - Dr. Abbasi

Pre Operatively

Please remember, even though you and your doctor have decided to move on to surgery for treatment, there is a large amount of work and time that goes into getting your surgery approved and coordinated. We thank you for your patience. Before you have surgery there are certain things that should or need to be met. Consult the following list to make sure that you are ready for the day of surgery.

Pre-op Physical

Physical examinations need to be completed within 30 days of your scheduled surgery. These exams are done by your primary care physician or internal medicine doctor and will be scheduled for you.

Nothing by Mouth

Please remember that you should not eat or drink anything starting at midnight the night before surgery.

Medications

Please ask at your pre-op physical or refer to the hand out we gave you to see if your medication should be continued until the day of surgery or stopped.

Brace Fitting

Often a brace or collar is given the day before surgery. Generally this appointment is made for you.

MRSA Screen

(methicillin-resistant Staphylococcus aureus)
MRSA is type of bacteria resistant to antibiotics. It is common to screen for MRSA prior to surgery to try and avoid unexpected complications.

Labs

Pre-op labs are required within 48 hours of the day of surgery. These must be done at the facility you are having surgery at.

Hotel

Many hospitals provide vouchers for the nearby hotels. Contact the hospital you will be having surgery at to ask about possible vouchers for discounted rates.

Things to Remember
  • Hand carry imaging of the area you are having surgery on. Often your doctor brings the required images, but any back up or help is appreciated.
  • Wear and bring comfortable clothes
  • Cell phone to call friends and family for rides, post op status, etc.
  • Make sure you have rides to and from the hospital
  • Walker or assist device
  • Paper and pen for writing down any questions you may have; to assure that they are answered.
  • Directions: know how to get to the hospital to avoid any obstacles in getting there.

 

POST OP INSTRUCTIONS

Posterior Cervical Fusion - Dr. Abbasi

Description of Procedure

There are many techniques used to fuse the spine, your surgeon will choose the type that he/she feels will bring the most amount of relief while reducing the risk of the surgery as much as possible. Although fusion techniques differ, the goal remains the same, stabilize the spine and reduce pain down the arms and/or upper back and neck. This is done by making room for the nerve so that the nerve is not rubbed, and by placing material to eventually "fuse" (meaning grow bone from one bone to the next, so there is no longer a joint that can move) the bones to stabilize the spine and hopefully keep you pain free.

As the bone heals from one bone to the next, just like how a cast would be used to splint a broken arm, a cast or support system is needed here too. To accomplish this, a framework of screws and rods are used to support and provide a stable environment promoting bone healing. It takes roughly a year for a fusion to solidify, due to this please remember to follow your restrictions and use common sense.

Neck/Shoulder pain

Headaches, neck pain, pain near and around your shoulder blades and into your arms are common post- operative pain/symptoms after a neck surgery. These symptoms are temporary almost always, but can take quite some time to resolve.

Arm pain

It is not uncommon to experience temporary increased or the same level of intensity of pain down one or both of your arms or shoulders. This can be due to us "cleaning off" your nerves, swelling, or just remnants of nerve irritation from prior to surgery. Please inform us however, if your pain is gradually worsens.

Appointments

Please see your primary care physician one week after surgery to have the incision examined. We would like to see you at Tristate Brain and Spine Institute one month after surgery. These appointments are occasionally made for you prior to discharge from the hospital by the nursing staff. Please ask the nursing staff or contact our office to confirm these appointments. You should have plain X-rays whenever you come back to clinic for visits. You can reach Tristate at (320) 763-8888 to set up an appointment with our Patient Access Representative team.

Restrictions

Do not bend or twist you neck. Remember this acronym "BLT". That is you should not Bend, Lift over 8 pounds, or Twist. We would like you to keep your cervical spine (meaning shoulder to head) as straight as possible. Do not lift over 8 pounds first two weeks, then not over 16 pounds after that. We will clarify on further restrictions at your follow up appointment. We highly recommend not lifting anything over shoulder height.

Medication Refills

The medications may not last until your one-month follow up appointment. Please have your pharmacy send us a refill request to our fax (fax # 320-200-7478). If the pharmacy is unwilling to send a fax, please give us a call. Many medications are monitored; it will speed up the process if we get the request from your pharmacy. Due to this monitoring, please allow ample time for medication requests such as these (narcotics) to be received, reviewed, and mailed to your pharmacy. Since many substances are controlled prescriptions, please expect drug screening at random intervals.

REMINDER: We prescribe post-operative medication for up to 90 days; use this time to set up other pain management services if medications are still required after the 90-day period.

Incision Care

The incision site was sewed under the skin, then stapled or sewn again to prevent the wound from re-opening. The staple or sutures that you can see are usually removed between 2-3 weeks after surgery. You should monitor the wound for signs of infection (see signs of infection). The wound is usually left open to air. If you find that you are extremely sweaty in the region, please place antibiotic ointment over the incision and cover with clean gauze. This gauze and reapplication of the ointment should be done twice a day for the first two weeks.

Signs of Infection

You or a significant other/caregiver should monitor your incision for signs of infection. Signs of infection are redness, swelling,
increased warmth to the touch, discharge from the wound, and a body temperature over 100.3˚F. If any signs of infection appear, please contact our office and/or your primary care.

Delayed Healing

If there is concern about delay in fusion then CT scans should be obtained. Certain things can delay your healing, stop your surgery from being successful, and/or increase your risk of requiring another surgery. These things include smoking or tobacco use, diabetes, poor general health, advanced age, and/or obesity. Some of these risks cannot be avoided, remember to control what you can for the best possible outcome.

Can I bathe?

You may get the incision wet in the shower, just pat dry the site with a clean towel when finished. However, avoid soaking in the bathtub. You do not want to soak the wound in water; this will increase your risk of infection at the incision site. Please wait around 3 weeks when the incision wound is well healed before taking baths to bathe.

Should I wear a brace?

Use brace when needed and ambulation as soon as possible, PT can help with that. Early PT will increase activity in an appropriate way.

When can I go back to work?

Most patients go back to work with restrictions 4-8 weeks after surgery. If you have a more physically demanding job, this may need to be extended. In this case, your capability to return to work can be discussed at your one month visit.

When can I drive?

Abstain from driving until off all narcotic pain medication. Once off medications, you should be able to safely operate your vehicle once again.